引用本文:陈郡兴,吴涯雯,苏志源,詹 鸿.熵指数和脑电双频指数对伤害性刺激反应能力的对比研究[J].中国临床新医学,2009,2(3):215-218.
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熵指数和脑电双频指数对伤害性刺激反应能力的对比研究
陈郡兴,吴涯雯,苏志源,詹 鸿
510150 广州,广州医学院第三附属医院麻醉科
摘要:
[摘要] 目的 通过观察麻醉诱导插管期间熵指数和脑电双频指数(BIS)的变化,比较两者对伤害性刺激(如气管插管)的反应能力。方法 20例择期手术病人入室后同时连接熵指数和BIS监护仪,进行常规气管内全麻,记录诱导前、意识消失时、插管前即刻、插管即刻、插管后1、3、5 min各时间点所对应的RE、SE、BIS数值以及心率、平均动脉压、脉搏血氧饱和度数值。结果 RE、SE、BIS值在诱导开始后逐渐下降,气管插管即刻RE、SE、BIS数值较插管前均明显升高,其中RE值升高最明显(P<0.01),随后恢复到插管前水平。气管插管后1 min MAP较插管前显著升高(P<0.01),气管插管后HR数值较插管前显著增加(P<0.01)。结论 熵指数、BIS和血流动力学指标均能及时反映气管插管刺激,其中RE值较SE、BIS值升高更明显、更快速。
关键词:  熵指数  脑电双频指数  全身麻醉  气管插管  伤害性刺激
DOI:10.3969/j.issn.1674-3806.2009.03.001
分类号:R 614.2
基金项目:广东省卫生厅科研基金项目(No.A2006531);广州市卫生局科研基金项目(No.2005-YB-045)
A comparison of capabilities of entropy versus bispectral index values reflecting the stimulation of injury
CHEN Jun-xing, WU Ya-wen, SU Zhi-yuan, et al.
Department of Anesthesiology, the Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, China
Abstract:
[Abstract] Objective To compare the capabilities of entropy versus bispectral index values reflecting the stimulation of injury.Methods 20 consenting ASA physical status I and II patients scheduled for elective surgery under general anesthesia were evaluated. Both the BIS sensor and entropy sensor electrode strips were simultaneously applied to the patient′s forehead. Anesthesia was induced with propofol 2mg/kg, fentanyl 4μg/kg and atracurium 0.6mg/kg. Sevoflurane 3% (initial inspired concentration) in combination with intermittent bolus doses of atracurium (0.1mg/kg) were administered for maintenance of anesthesia. At the time-point of baseline, loss of consciousness, before, immediately, and 1min to 5min after intubation, the values of RE, SE, BIS, HR, MAP and SpO2 were recorded.Results The BIS, RE, and SE values decreased progressively from preinduction (baseline) values of 97±1, 89±2 and 96±4 to 5 min after intubation values of 41±10, 40±10 and 41±9, respectively. Compared to the values of before intubation, RE, SE and BIS of immediately at intubation were significantly increased, especially the RE value (P<0.01). MAP at the time-point of 1min after intubation were significantly increased compared to the value before intubation(P<0.01). HR at the time-point of immediately and 1min after intubation were significantly increased compared to the value before intubation(P<0.01).Conclusion Entropy and BIS indexes and homodynamic indictors (MAP and HR) can reflect promptly the stimulation of tracheal intubation, especially the RE value.
Key words:  Entropy index  Bispectral index  General anesthesia  Tracheal intubation  Stimulation of injury